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Washington rates for HCPCS 99416

Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (List separately in addition to code for prolonged service)

Professionalmedian $7 · 10th–90th $3–$200%10%10th90th$7$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.89 / $14.45
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $10.00 / $22.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $9.33 / $26.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.39 / $4.68 / $19.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $14.13 / $23.99
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $10.00 / $22.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $7.08 / $15.14
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $15.49 / $29.51